MEDICARE: BETTY A HINDERKS DAVIS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ND0101X	MOHS-Micrographic Surgery Physician	33887	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417906280
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETTY A HINDERKS DAVIS MD

Provider Business Mailing Address
First Line	:	10240 W INDIAN SCHOOL RD STE 115
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85037-5905
Country	:	US
Telephone Number	:	623-243-9077
Fax Number	:	623-271-9826

Provider Business Practice Location Address
First Line	:	14725 W MOUNTAIN VIEW BLVD
Second Line	:
City	:	SURPRISE
State	:	AZ
Zip	:	85374-2704
Country	:	US
Telephone Number	:	623-243-9077
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	05/02/2025

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